@extends('layouts.app')

@section('content')
<section class="page-header row">
	<h2> {{ $pageTitle }} </h2>
	<ol class="breadcrumb">
		<li><a href="{{ url('') }}"> Dashboard </a></li>
		<li><a href="{{ url('/manage/'.$pageModule) }}"> {{ $pageTitle }} </a></li>
		<li class="active"> Form  </li>		
	</ol>
</section>
<div class="page-content row">
	<div class="page-content-wrapper no-margin">
	
	{!! Form::open(array('url'=>'/manage/claimcomment?return='.$return, 'class'=>'form-vertical validated','files' => true )) !!}
	<input type="hidden" name="status_type" value="{{ $pageTitle }}" />
	
		<div class="sbox-title clearfix">
			<div class="sbox-tools pull-right" >
				<a href="{{ url('/manage/'.$pageModule.'?return='.$return) }}" class="tips btn btn-sm "  title="{{ __('core.btn_back') }}" ><i class="fa  fa-times"></i></a> 
			</div>
			<div class="sbox-tools1 pull-left1" >
				<button name="apply" class="btn btn-sm btn-primary  "  title="{{ __('core.btn_back') }}" ><i class="fa  fa-check"></i> {{ __('core.sb_apply') }} </button>
				<button name="save" class="btn btn-sm btn-success"  title="{{ __('core.btn_back') }}" ><i class="fa  fa-paste"></i> {{ __('core.sb_save') }} </button> 
				<?php if($frontendSlug!='') {
				$fsconfig = explode('@',$frontendSlug);
				if( ($row[$fsconfig[1]]) ) 
				echo '<a  class="btn btn-sm btn-outline-primary" target="_blank"  title="FrontEnd" href="'. (config('website.cnf_appurl') .'/'.config('website.cnf_lang') . str_replace('//','/',('/'.$fsconfig[0].'/'.$row[$fsconfig[1]]))).'"><i class="fa  fa-desktop"></i> FrontEnd</a>';
				 } ?>
			</div>
		</div>	
		<div class="sbox1">
		<div class="sbox-content clearfix row">
		<div class="col-xs-12">
	<ul class="parsley-error-list">
		@foreach($errors->all() as $error)
			<li>{{ $error }}</li>
		@endforeach
	</ul>		

	<?php $curTime = time();?>

<div class="sbox1"><div class="col-md-6">
						<fieldset class="sbox" style="border-top:0; border-radius: 5px;"><legend> Claim Comment</legend>
				<?php if( !isset($row['id']))  $row['id'] = null;   ?>
		<input  type='hidden' name='id' id='id' value='{{$row['id']}}' />
									
									  <div class="form-group  depen-  wrap-claim_id  " >
										<label for="ipt" class=" control-label "> Claim Id    </label>
										
										
										  <?php if( !isset($row['claim_id']))  $row['claim_id'] = null;   ?>
		<input  type='number' name='claim_id' id='claim_id' value='{{ $row['claim_id'] }}' 
						       class='form-control is_number'  /> 						
									  </div> 					
									  <div class="form-group  depen-  wrap-comment  " >
										<label for="ipt" class=" control-label "> Comment    </label>
										
										
										  <?php if( !isset($row['comment']))  $row['comment'] = null;   ?>
		<textarea name='comment' rows='5' id='comment' class='form-control input-sm '  
				             >{{ $row['comment'] }}</textarea> 						
									  </div> <?php if( !isset($row['updated_at']))  $row['updated_at'] = null;   ?>
		<input  type='hidden' name='updated_at' id='updated_at' value='{{ date("Y-m-d H:i:s") }}' /></fieldset>
			</div>
			
			<div class="col-md-6">
						<fieldset class="sbox" style="border-top:0; border-radius: 5px;"><legend> Additional Details</legend>
									
									  <div class="form-group  depen-  wrap-commented_by  " >
										<label for="ipt" class=" control-label "> Commented By    </label>
										
										
										  <?php if( strlen($row['commented_by']) < 1 )  $row['commented_by']  = 'admin'; 	  ?>
		
					<?php $commented_by = explode(',',$row['commented_by']);
					$commented_by_opt = array( 'admin' => 'Admin' ,  'user' => 'User' , ); ?>
					<select name='commented_by' rows='5'   placeholder='Select Commented By' data-placeholder='Select Commented By'    class='select2'  > 
						<?php 
						foreach($commented_by_opt as $key=>$val)
						{
							echo "<option  value ='$key' ".($row['commented_by'] == $key ? " selected='selected' " : '' ).">$val</option>"; 						
						}						
						?></select> 						
									  </div> 					
									  <div class="form-group  depen-  wrap-created_at  " >
										<label for="ipt" class=" control-label "> Created At    </label>
										
										
										  <?php if( strlen($row['created_at']) < 1 )  $row['created_at']  = '2019-11-05 06:30:48'; 	  ?>
		
				<div class="input-group m-b" style="width:150px !important;">
				
				<input  type='text' name='created_at' id='created_at' value='{{ $row['created_at'] }}' 
				       class='form-control input-sm @if(trim('  ')!='readonly') datetime @endif ' />

					<span class="input-group-addon calwrap"><i class="fa fa-calendar"></i></span>
				</div>
				 						
									  </div> </fieldset>
			</div>
			
			
		</div>
		
		
</div>
</div>
</div>
@include('/manage/'.$pageModule.'/subform')

		
		
		<div class="sbox-title clearfix">
			<div class="sbox-tools pull-right" >
				<a href="{{ url('/manage/'.$pageModule.'?return='.$return) }}" class="tips btn btn-sm "  title="{{ __('core.btn_back') }}" ><i class="fa  fa-times"></i></a> 
			</div>
			<div class="sbox-tools pull-left" >
				<button name="apply" class=" btn btn-sm btn-primary  "  title="{{ __('core.btn_back') }}" ><i class="fa  fa-check"></i> {{ __('core.sb_apply') }} </button>
				<button name="save" class=" btn btn-sm btn-success"  title="{{ __('core.btn_back') }}" ><i class="fa  fa-paste"></i> {{ __('core.sb_save') }} </button> 
			</div>
		</div>	
		
	
	
	<input type="hidden" name="action_task" value="save" />
	{!! Form::close() !!}
	</div>
</div>		

	
		 
   <script type="text/javascript">
	$(document).ready(function() { 
		
		
		 		 

		$('.removeMultiFiles').on('click',function(){
			var removeUrl = '{{ url("claimcomment/removefiles?file=")}}'+$(this).attr('url');
			$(this).parent().remove();
			$.get(removeUrl,function(response){});
			$(this).parent('div').empty();	
			return false;
		});		
		
	});
	</script>		 
@stop